This review examines the therapeutic potential of neuromodulation methods, including neurofeedback, transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS), as non-pharmacological interventions for children with attentiondeficit/hyperactivity disorder (ADHD). A comprehensive review of current studies was conducted, focusing on each technique’s mechanism, application, and efficacy in managing ADHD symptoms and cognitive deficits. Studies included human participants with ADHD, evaluating changes in symptom severity and cognitive outcomes. Neurofeedback demonstrated efficacy in symptom reduction, particularly when combined with pharmacotherapy, yielding sustained improvements. tDCS showed moderate efficacy, especially in attention and impulsivity control; however, variability in protocols and pediatric response highlights the need for standardization. TMS exhibited mixed outcomes, with high-frequency TMS targeting the dorsolateral prefrontal cortex indicating potential cognitive benefits, though results were inconsistent across studies. Neuromodulation presents a promising complementary approach for ADHD treatment in children, potentially addressing limitations of pharmacotherapy. Future research should focus on optimizing stimulation parameters, increasing sample sizes, and refining methodologies to establish neuromodulation as part of standard ADHD treatment protocols.

Purpose: Adjuvant chemotherapy (AC) is recommended for muscle-invasive or lymph node-positive upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). However, disease recurrences are frequently observed in pT1 disease, and AC may increase the risk of overtreatment in pT2 UTUC patients. This study aimed to validate a risk-adapted scoring model for selecting UTUC patients with ≤pT2 disease who would benefit from AC. Materials and Methods: We retrospectively analyzed 443 ≤pT2 UTUC patients who underwent RNU. A risk-adapted scoring model was applied, categorizing patients into low- or high-risk groups. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed according to risk group. Results: Overall, 355 patients (80.1%) and 88 patients (19.9%) were categorized into the low- and high-risk groups, respectively, with the latter having higher pathological stages, concurrent carcinoma in situ, and synchronous bladder tumors. Disease recurrence occurred in 45 patients (10.2%), among whom 19 (5.4%) and 26 (29.5%) belonged to the low- and high-risk groups, respectively (p<0.001). High-risk patients had significantly shorter RFS (64.3% vs. 93.6% at 60 months; hazard ratio [HR] 13.66; p<0.001) and worse CSS (80.7% vs. 91.5% at 60 months; HR 4.25; p=0.002). Multivariate analysis confirmed that pT2 stage and the high-risk group were independent predictors of recurrence and cancer-specific death (p<0.001). Decision curve analysis for RFS showed larger net benefits with our model than with the T stage model. Conclusions The risk-adapted scoring model effectively predicts recurrence and identifies optimal candidates for AC post RNU in non-metastatic UTUC.

This review examines the therapeutic potential of neuromodulation methods, including neurofeedback, transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS), as non-pharmacological interventions for children with attentiondeficit/hyperactivity disorder (ADHD). A comprehensive review of current studies was conducted, focusing on each technique’s mechanism, application, and efficacy in managing ADHD symptoms and cognitive deficits. Studies included human participants with ADHD, evaluating changes in symptom severity and cognitive outcomes. Neurofeedback demonstrated efficacy in symptom reduction, particularly when combined with pharmacotherapy, yielding sustained improvements. tDCS showed moderate efficacy, especially in attention and impulsivity control; however, variability in protocols and pediatric response highlights the need for standardization. TMS exhibited mixed outcomes, with high-frequency TMS targeting the dorsolateral prefrontal cortex indicating potential cognitive benefits, though results were inconsistent across studies. Neuromodulation presents a promising complementary approach for ADHD treatment in children, potentially addressing limitations of pharmacotherapy. Future research should focus on optimizing stimulation parameters, increasing sample sizes, and refining methodologies to establish neuromodulation as part of standard ADHD treatment protocols.

This review examines the therapeutic potential of neuromodulation methods, including neurofeedback, transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS), as non-pharmacological interventions for children with attentiondeficit/hyperactivity disorder (ADHD). A comprehensive review of current studies was conducted, focusing on each technique’s mechanism, application, and efficacy in managing ADHD symptoms and cognitive deficits. Studies included human participants with ADHD, evaluating changes in symptom severity and cognitive outcomes. Neurofeedback demonstrated efficacy in symptom reduction, particularly when combined with pharmacotherapy, yielding sustained improvements. tDCS showed moderate efficacy, especially in attention and impulsivity control; however, variability in protocols and pediatric response highlights the need for standardization. TMS exhibited mixed outcomes, with high-frequency TMS targeting the dorsolateral prefrontal cortex indicating potential cognitive benefits, though results were inconsistent across studies. Neuromodulation presents a promising complementary approach for ADHD treatment in children, potentially addressing limitations of pharmacotherapy. Future research should focus on optimizing stimulation parameters, increasing sample sizes, and refining methodologies to establish neuromodulation as part of standard ADHD treatment protocols.

OBJECTIVE: To study the in vitro and in vivo antitumor effects of the polysaccharide of Alocasia cucullata (PAC) and the underlying mechanism. METHODS: B16F10 and 4T1 cells were cultured with PAC of 40 µg/mL, and PAC was withdrawn after 40 days of administration. The cell viability was detected by cell counting kit-8. The expression of Bcl-2 and Caspase-3 proteins were detected by Western blot and the expressions of ERK1/2 mRNA were detected by quantitative real-time polymerase chain reaction (qRT-PCR). A mouse melanoma model was established to study the effect of PAC during long-time administration. Mice were divided into 3 treatment groups: control group treated with saline water, positive control group (LNT group) treated with lentinan at 100 mg/(kg·d), and PAC group treated with PAC at 120 mg/(kg·d). The pathological changes of tumor tissues were observed by hematoxylin-eosin staining. The apoptosis of tumor tissues was detected by TUNEL staining. Bcl-2 and Caspase-3 protein expressions were detected by immunohistochemistry, and the expressions of ERK1/2, JNK1 and p38 mRNA were detected by qRT-PCR. RESULTS: In vitro, no strong inhibitory effects of PAC were found in various tumor cells after 48 or 72 h of administration. Interestingly however, after 40 days of cultivation under PAC, an inhibitory effect on B16F10 cells was found. Correspondingly, the long-time administration of PAC led to downregulation of Bcl-2 protein (P<0.05), up-regulation of Caspase-3 protein (P<0.05) and ERK1 mRNA (P<0.05) in B16F10 cells. The above results were verified by in vivo experiments. In addition, viability of B16F10 cells under long-time administration culture in vitro decreased after drug withdrawal, and similar results were also observed in 4T1 cells. CONCLUSIONS Long-time administration of PAC can significantly inhibit viability and promote apoptosis of tumor cells, and had obvious antitumor effect in tumor-bearing mice.
Mice ; Animals ; Alocasia/metabolism* ; MAP Kinase Signaling System ; Caspase 3/metabolism* ; Apoptosis ; RNA, Messenger/metabolism*

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Background and Objectives: Although cardiac rehabilitation (CR) is highly recommended in patients with cardiovascular disease (CVD), participation in CR is low mainly due to access barriers. Home-based CR (HBCR) has been recommended to overcome access barriers.Exercise is a core component of CR and should be developed and implemented based on individual characteristics. We aimed to assess physical activity behaviors, exercise preferences, and exercise barriers to understand physical activity characteristics of CVD patients. Methods: Participants were patients between the ages 19 to 75 years with a history of heart failure with reduced ejection fraction (HFrEF) or myocardial infarction (MI). They completed a cross-sectional survey at a tertiary hospital's outpatient clinic from April to June 2021. Survey data included physical activity levels, patterns, preference, and barriers of exercise. Results: Participants (n=189; 143 males, 46 females, 62.1±12.0 years) were diagnosed as either HFrEF (n=160, 84.7%) or a history of MI (n=97, 51.3%). Only 26.5% of patients engaged in moderate to vigorous exercise for more than 150 minutes per week. Participants preferred exercising alone or with families. Walking (65.6%) and resistance exercises (35.4%) were favored, with outdoor (37%) and home-based (30.2%) settings preferred over fitness centers (10.6%) and hospitals (0.5%). Barriers to exercise included fatigue (34.4%), poor health perception (31.7%), and low fitness levels (30.7%). Conclusions The results of this study can be used to develop tailored HBCR programs that consider individual preferences and address specific barriers, facilitating adequate physical activity engagement.